BTr FORM 3

WAIVER OF CONFIDENTIALITY

KNOW ALL MEN BY THESE PRESENTS:

That in compliance with our Undertaking dated ________________, in favour of the Bureau
of Treasury and the Authorized Government Depository /Servicing bank, We, Bulanao East
Elementary School hereby unconditionally waive our right to secrecy of bank

Deposits under the Bank Secrecy Law over Account Number__________________________

Land Bank of the Philippines __ in favour of the Bureau of Treasury /Treasurer of the

Philippines or Representative and the bank branch to which the bank account is opened and
maintained.

That we declare that we have read this document and have fully understood its contents. We
further declare that we voluntarily and willingly executed this Waiver with full knowledge of our rights
under the law.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___________________

day of_ February , 2020.
Name of Agency _Bulanao East Elementary School

By:___ JOAN M. DALILIS

Head of Agency/ Authorized Representative

SUBSCRIBED AND SWORN to before me this day of _____________________________,

affiant exhibited to me competent proof of his identity.

Notary Public
Doc. No. _______
Page No _______
Book No. _______
Series of _______